It’s with regret today that I rise to speak to Bill 60, the government’s plan to introduce two-tier health care in Ontario. Public health care is a key component of our identity in Canada. Unlike our neighbours to the south, we made a decision that we weren’t going to let wealth determine people’s access to vital health care. We created a public medicare system that ensures everyone is able to get the health care they need, when they need it, without any question of how much money they have. People don’t have to go deeply into debt or sell off homes or businesses just because a family member got sick. People without money don’t need to worry that people with more money are going to come along and bump them out of the way. Access to health care is based on the urgency of your condition instead of your bank account.

Conservatives have never liked this system. They’ve always hated the fact that you can’t buy your way to the front of the line, and we know there have always been many people lobbying them, salivating over the opportunity to make a lot of money off of people in need. So, over the past four years, they’ve been hard at work generating a crisis.

Admittedly, the past Liberal government wasn’t great at managing health care either. They cut and underfunded until people were being treated in hallways—hallway medicine, everyone called it. But, under this Premier, we’ve gone from hallway medicine to no medicine. Emergency rooms are closed, so people can’t even get into the hallways. We’ve got beds and operating rooms that are empty despite the demand for health care, the long wait-lists, because we don’t have nurses and health care workers to staff them.

I guess it’s “mission accomplished” for the Premier and for the private, for-profit health care industry that has been lobbying him so hard for the past few years. Now that he has made the crisis so bad that nurses are leaving the profession in droves, now that people are waiting 12 hours at the emergency room, now that the wait-lists for surgeries are so long, the Premier has decided that this is the moment to really stick the knife in public health care and introduce two-tier health care in Ontario.

Make no mistake: This is deliberate. This government has set up public health care to fail so they could replace it with a for-profit model to line the pockets of their wealthy friends. And it is Ontarians—as always, with this government—that will pay the price, that will have to pull out their credit cards to pay for health care at these private facilities, that will wait even longer for health care in our public system as they bleed even more health care workers out of our hospitals, that will have to pay the taxes that are going into the pockets of private shareholders instead of to strengthening and expanding our public health care system.

This is part of a pattern with this government. Whether it’s the development of the greenbelt, the refusal to invest in public education or the destruction of public health care, we see this government constantly make decisions that don’t help people with the very real challenges that they face every day but somehow manage to make a bunch of friends and lobbyists around the Premier a lot of money.

We’ve seen this pattern with health care throughout this government’s time in office and throughout the pandemic. They took away public oversight of home care, leaving people vulnerable to the whims of for-profit companies. They granted licences to for-profit long-term-care providers that had hugely disproportionate death rates and they took away the rights of family members to sue. They contracted out PCR COVID testing to for-profit companies, leading to Ontarians having to pay $200 out of pocket to be tested because publicly accessible tests were so tightly rationed—unless you happened to attend a private school. And they’ve been expanding private clinics.

This most recent bill is not the innovative, bold or creative solution to surgical backlogs the health minister has claimed it is. It is the oldest trick in this government’s book: Put further pressure on an already struggling sector and offer privatization as the only way out.

If this government really wanted to address the current concerns in the health care sector, they would actually listen to nurses and health care workers about why they are leaving the health care sector and stop their appeal to try to save Bill 124, a bill that the courts found unconstitutional, a bill that nurses and health care workers have told this government they found profoundly disrespectful—humiliating, even—at a moment when they were working so incredibly hard throughout the pandemic, with their wages capped well below the rate of inflation.

I was at the pre-budget hearing in Ottawa, where nurses said that they were leaving the profession because of Bill 124 and that they found Bill 124 profoundly humiliating. Instead of listening to them, government members of the committee got into arguments with them. Nurses were literally telling them, “We’re leaving because of Bill 124,” and the government was saying, “No, that’s definitely not it.” How profoundly disrespectful is that?

What’s even more disrespectful is that government members tried to claim that it wasn’t Bill 124 that’s causing the shortage, because other jurisdictions also have a shortage of health care workers. Well, if other jurisdictions also have a shortage of health care workers, then how foolish is it to cap the wages of our health care workers and drive them away when there are job opportunities in other provinces?

If the government actually wanted to improve health care, they would focus on recruiting, retaining and returning nurses to our health care system—and personal support workers and other health care workers—providing them with better pay, better working conditions and the respect they deserve.

The government could work on licensing tens of thousands of internationally educated nurses and doctors already in Ontario, who are waiting years and paying thousands to have their credentials certified. The government could also fund hospitals across the province so that they have enough staff on every shift and on every ward, so that rooms don’t sit empty due to understaffing.

Make no mistake: The bottleneck for the surgical wait-list in Ontario is not due to a lack of operating space, it is due to a lack of staff for these operating rooms. Operating rooms are sitting empty because hospitals don’t have the resources to staff the ORs they already have. And now this government is trying to create a parallel system which will pull more staff out of our publicly funded system.

This move is also going to cost our health care system more. Services in private clinics receive more money than our public hospitals do for the same service, meaning that when private facilities perform surgeries, Ontario tax dollars will be going right into the pockets of shareholders that have invested in these facilities. The government’s actions will lead to investors making large profits off the backs of sick Ontarians.

Meanwhile, our hospitals depend on economies of scale to be able to fund more complex surgeries. So when we pull services out of the hospital, we leave the hospital trying to provide the more complex surgeries and the people with complications requiring longer surgeries, but we’re paying the hospitals less money than the private facilities are getting for simple surgeries, so we’re actually making it harder for the hospitals to pay the cost of these surgeries.

And while these clinics are able to charge our health care system more for the services they provide, they can also charge extra fees directly to the patients who are being sent there by this government. These fees take the form of consulting fees or membership fees that patients are made to cover in order to receive the health care they desperately need. We also know that many patients are upsold by doctors keen to make a profit.

But it’s not just people who are getting surgeries or procedures at private clinics who will be paying a price for this government’s policies; patients using the public system will also pay a price. They’re already paying a price now for Bill 124, with 12-hour wait times or longer at emergency rooms.

The Ottawa Hospital has had many times over the past year where they have been short as many as 800 nurses. They’ve had to get creative, and these absences are filled with unregulated, unlicensed care providers, not trained, professional registered nurses. In January, the Ottawa Hospital lost more nurses than they were able to recruit. While this is happening, this government has chosen to suppress nurses’ wages, ignore their concerns and undervalue their profession, while people are working in unbelievable conditions.

Here’s why this really matters, Speaker: There’s not a magical pool of nurses and health care workers that we just haven’t tapped yet who are suddenly going to appear and fill these positions in private health care facilities. These nurses and health care workers are going to come from our public system. And when we’re capping their wages in the public system, when we are putting them into unsustainable and dangerous working conditions, when nurses are already leaving to work at Costco because it’s less stressful, then why wouldn’t they leave to take a job at a private facility that only works weekdays from 9 to 5 and doesn’t have a wage cap?

This move is only going to pull more nurses and health care workers out of our system, leaving public health care in an even more precarious state, lengthening wait times for everyone, and the minister’s toothless staffing plan requirement isn’t going to address that, as we’ve already seen at the Riverside hospital in Ottawa, because that’s not a magic wand that can miraculously create more health care workers.

Ontario’s public health care system needs fixing. It absolutely needs fixing, but by allowing for-profit companies to offer health care services that were originally done by the public sector, this government is instead ensuring that sooner or later, those with more money will have access to better health care faster than other Ontarians, and this is unacceptable.

And so, Speaker, here we see another pattern emerging: Ontario residents are demanding better, health care workers are demanding better, but instead of listening to them, working with them and investing in the system, the government is enriching some private, for-profit corporations that lobbied really hard. Shame on them.

Thank you very much, Speaker. It’s a pleasure to see you in the chair; it’s the first time.

It is always an honour to rise in this House to represent and speak on behalf of the good people of my riding, Hamilton West–Ancaster–Dundas. This Bill 60 and the changes that this government is making to our public health care system are of significant concern to the people in my riding. They call to share their hopes and their dreams and—I’ve been hearing so much from my constituents—to ask the question: Why is this government rushing to dismantle our public health care system, our publicly delivered, world-class health care system that has been the envy of the world?

As has been said here, health care is in crisis. We acknowledge that; we recognize it’s in a crisis, but it’s this government’s job to fix that crisis with the solutions they already have before them, not in fact to make it worse. For example, in Hamilton, we have world-class health care facilities. We have Hamilton Health Sciences, we have McMaster Children’s Hospital and we have St. Joseph’s. These are world-class hospitals that are struggling under the underfunding, the lack of funding, the lack of supports they need to be able to continue to deliver the health care the people of Hamilton need. It’s been said many, many times here that the solutions—in fact, it’s been said that you’ve manufactured this crisis, taken hallway health care that was a legacy of the Liberals and doubled down by making it worse by underfunding health care, and by introducing Bill 124, that has created and exacerbated a health care human resource crisis.

It’s a mystery to me why this government would, rather than the easy solutions which are to fund the health care hospitals we have, these world-class hospitals, cut them off and let them have to put people on wait-lists for surgery. Why you wouldn’t make sure they have the adequate funding? Why you wouldn’t make sure that the money you have in contingency funds and $12 billion of unspent money could be going right now to address wait-lists? Why are you not doing that? Why is that not your first choice?

Why are there 12,000 children on a surgery wait-list in the province of Ontario when you could start to address that by making sure these closed operating suites, these unused facilities are open again so that people could start getting the procedures and the surgeries they need to save lives, relieve pain and suffering and the fears of parents who are hoping that their children would get the care they deserve under this government?

I also wonder why you continue to disrespect health care workers, nurses and PSWs and refuse to repeal Bill 124. You continue to underpay them in a time when they are burnt out, stressed and doing the best they can in a system that you have destabilized further. Why are you taking nurses and PSWs back to court on Bill 124 when it’s been shown that this is an unconstitutional bill? Why is that not your first act?

The question really stands: Why are you rushing, rather than looking at the solutions that are before you? Why is your first act, the thing you’re putting all your effort into, to introduce profits into the health care system? It’s been called the profitization of our health care system, and it’s hard to describe it as anything other than that.

We have talked in this House about the proud history of the NDP and Tommy Douglas and our medicare system. All of you know, and all of you have been hearing from your constituents, that that is the pride of Ontario. That’s one of the things we’re so proud of: that people can get access to the health care and the emergency care they need, despite their ability to pay, anywhere in this province. To now go down the road of a two-tier health care system is exactly the wrong, wrong direction and nobody, if they understood what you are doing, would support this. I can only imagine that you are also hearing from your constituents that this is not what they expected and this is not where they want to see you going with their precious health care system.

Rather than taking the steps that you know will help to relieve the burden and will help to improve our publicly delivered health care system, you’re still rushing to introduce privatization without learning the lessons of the past. In this bill, there are absolutely no protections for patients seeking care in private, for-profit, corporatized facilities. It’s not in the bill. All you have to do is to look at the evidence that comes from what already exists in private, independent health facilities.

The report from the Auditor General is invaluable, and I wonder whether the opposite members, the MPPs or the ministers, have taken into account the findings of this value-for-money audit that the Auditor General has put out, because the warnings are there. The recommendations to protect patients both financially and health outcomes are in this report, but nothing has been put into this bill to address that.

Let me just point out some of the highlights—not really highlights; some of the actual dire warnings or recommendations that come from this report that should have been included in this bill but are not there.

I’m just going to start by—it’s interesting reading if you take the time to look at it, but really, the Auditor General said that there is “inadequate and inconsistent monitoring of the quality of outpatient surgeries.” No one is monitoring the results, the outcome of how people fare after they have surgeries or procedures in these independent health care facilities. There’s inadequate monitoring.

There’s also “no regular review and monitoring of funding and billings for outpatient surgeries.” So it’s all fine and dandy for you to say that people won’t have to pay extra—it’s absolutely not the truth, because in Ontario, people already pay extra for these procedures. They pay dearly for these procedures.

In fact, the Auditor General goes on to say that there’s absolutely “no provincial oversight to protect patients against inappropriate charges.” The ministry has not sufficiently reviewed “unusual billing patterns or trends to identify possible issues, such as inappropriate billings or inappropriate rendering of services.” These are the findings that the Auditor General did in 2021, and these problems still exist and are only going to be exacerbated by this bill.

I think the overall conclusion of the Auditor General that speaks to the two protections that people should expect from a government—to protect them financially and to protect their health outcomes—when they’re being driven by this government to private, for-profit clinics, the Auditor General says, clearly, “The ministry does not have a centralized way to measure and report on surgical quality and outcomes for all surgeries being performed in Ontario.” That’s shocking. There’s no oversight in place, and this bill does not put any in place.

The Auditor General also goes on to say that “We found that some patients could be given misleading information as part of sales practices to make a profit.” So the warning is here. This is already happening. The quality of people’s outcomes are not being monitored, and the fact they’re being charged inappropriately and overcharged for fees is not at all being addressed by this government. I would be curious to know what the government is doing to address these recommendations and these findings from the Auditor General.

The Auditor General’s work is invaluable to all of us in this House to do our work. Her work is stellar, and her work is invaluable. She’s an independent officer of this Legislature, and we should be listening to this and using this to make our bills better and to improve our bills. She said, mincing no words, that “the ministry is putting patients at greater financial risk by allowing additional private organizations to provide publicly funded surgeries while also being allowed to charge patients directly for additional uninsured services to make a profit without appropriate oversight mechanisms in place.”

There it is. It’s happening already in this province. You’re putting a bill forward that’s going to double down on this and that has not in any way addressed those concerns.

My question to the government would be, what happens if something goes wrong in one of these private clinics? What is the procedure when there are complications or urgent issues that arise? How will this impact our emergency rooms that are already closing? Have you considered any of this? Because it’s not in the bill, and in the debate that I’ve heard, you don’t address any of the concerns that people have.

So I would just say, despite the despair that we feel that this government is not protecting people when they need health care in this province—that in fact, you’re protecting profits over patients—I just have to end with a quote from Tommy Douglas, because it is the anniversary of his passing. Despite the despair that we feel, I think Tommy’s words would be, "Courage, my friends; ’tis not too late to build a better world.” That’s what we should be aspiring to, not a downward spiral to privatization and lack of services for the people of the province of Ontario.